Patel Harshida, Berg Marie, Barasa Anders, Begley Cecily, Schaufelberger Maria
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
Midwifery. 2016 Jan;32:14-20. doi: 10.1016/j.midw.2015.10.001. Epub 2015 Oct 10.
Peripartum Cardiomyopathy is a form of cardiac disease often associated with cardiac failure, occurring in late pregnancy or after childbirth. The anatomical and physiological changes in the mother associated with normal pregnancy are profound, and this may result in symptoms and signs that overlap with Peripartum Cardiomyopathy, leading to missed or delayed diagnosis. Women's experiences of Peripartum Cardiomyopathy symptoms remain poorly studied. The aim of this study was to explore and describe women's experiences of symptoms in Peripartum Cardiomyopathy.
A triangulation of methods with individual interviews and data from medical records.
Mothers with Peripartum Cardiomyopathy diagnosis were recruited from Western Sweden as a part of research project.
19 women were interviewed and medical records were reviewed by authors.
All interview transcripts were analysed using qualitative inductive content analysis to identify key themes.
The main theme, meaning of onset and occurrence of symptoms is captured in the metaphor: being caught in a spider web, comprising subthemes, invasion of the body by experienced symptoms and feeling of helplessness. Symptoms related to Peripartum Cardiomyopathy started for 17 women during pregnancy and in two post partum and time from symptoms to diagnosis varied between three and 190 days (median 40). The physical symptoms were:shortness of breath, excessive fatigue and swelling, bloatedness, nausea, palpitation, coughing, chest tightness, bodily pain, headache, fever, tremor, dizziness, syncope, restless and tingly body and reduced urine output. Emotional symptoms were: fear, anxiety, feelings of panic, and thoughts of impending death.
Symptoms of Peripartum Cardiomyopathy were debilitating, exhausting and frightening for the women interviewed in this study. Health care professionals responsible for the antenatal care, especially midwives, need skills to identify initial symptoms of Peripartum Cardiomyopathy for early referral and treatment by a specialist. In order to give optimal care more research is needed to show how to improve midwives' knowledge of Peripartum Cardiomyopathy.
围产期心肌病是一种常与心力衰竭相关的心脏病形式，发生在妊娠晚期或产后。母亲在正常妊娠期间发生的解剖学和生理学变化非常显著，这可能导致与围产期心肌病重叠的症状和体征，从而导致诊断遗漏或延迟。对围产期心肌病症状的女性经历研究较少。本研究的目的是探索和描述围产期心肌病女性的症状经历。
采用个人访谈和病历数据的方法进行三角验证。
作为一项研究项目的一部分，从瑞典西部招募了被诊断为围产期心肌病的母亲。
对19名女性进行了访谈，并由作者查阅了病历。
所有访谈记录均采用定性归纳内容分析法进行分析，以确定关键主题。
主要主题，即症状的发作和出现的意义，用隐喻来描述：被困在蜘蛛网中，包括子主题，即经历的症状对身体的侵袭和无助感。17名女性在怀孕期间开始出现与围产期心肌病相关的症状，2名在产后出现，从症状出现到诊断的时间在3至190天之间（中位数为40天）。身体症状包括：呼吸急促、极度疲劳、肿胀、腹胀、恶心、心悸、咳嗽、胸闷、身体疼痛、头痛、发烧、震颤、头晕、晕厥、身体不安和刺痛以及尿量减少。情绪症状包括：恐惧、焦虑、恐慌感以及濒死感。
围产期心肌病的症状对本研究中接受访谈的女性来说是虚弱、疲惫和可怕的。负责产前护理的医疗保健专业人员，尤其是助产士，需要具备识别围产期心肌病初始症状的技能，以便早期转诊并由专科医生进行治疗。为了提供最佳护理，需要更多研究来表明如何提高助产士对围产期心肌病的认识。
